Use of "Lean" Among Electronic Dance Music Party Attendees

Am J Addict. 2019 Sep;28(5):347-352. doi: 10.1111/ajad.12897. Epub 2019 Apr 30.


Background/objectives: Lean (a.k.a.: Sizzurp, Purple Drank) is a recreational beverage that commonly contains codeine cough syrup. Despite its popularization in the hip-hop music scene, few epidemiologic studies have examined use. This study examined prevalence and correlates of use among a population at high-risk for drug use-electronic dance music (EDM) party attendees.

Methods: A total of 1029 EDM party attendees (ages 18-40) were surveyed in New York City in 2018 using time-space sampling. Prevalence and correlates of use of Lean were estimated.

Results: An estimated 15.5% of attendees have ever used Lean, and 3.4% of attendees have used in the past year. Only an estimated 0.2% have used in the past month, but 14.2% would use in the next month if offered by a friend. Three-quarters (75.4%) of users believed their Lean ever contained codeine and 32.4% believed it always or usually contained codeine. Past-year use was strongly associated with past-year nonmedical prescription opioid use (adjusted odds ratio = 10.77, P = 0.003), but not past-year use of other illegal drugs. Attendees who are black or bisexual are at higher odds for past-year use, and those with a college degree or higher are at lower odds for past-year use.

Discussion and conclusions: While use of Lean is not as prevalent as use of various other drugs (eg, ecstasy) in this high-risk population, over a tenth have tried it and/or are willing to use it if offered.

Scientific significance: Prevention efforts need to target potential users as frequent use of beverages containing codeine products can lead to dependence. (Am J Addict 2019;28:347-352).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Bisexuality
  • Codeine / adverse effects*
  • Dancing
  • Drug Users / statistics & numerical data
  • Female
  • Humans
  • Illicit Drugs
  • Male
  • Music
  • New York City / epidemiology
  • Odds Ratio
  • Opioid-Related Disorders / epidemiology*
  • Prescription Drug Misuse / statistics & numerical data
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires
  • Young Adult


  • Illicit Drugs
  • Codeine